I was changing baby when I had a stroke

AMANDA Douglas will never forget the moment. She was changing her baby's nappy when her world changed dramatically. 'I was sitting on the floor,' she says. 'When I tried to stand up, I couldn't do it, and when I tried to tell my husband what was wrong, the words came out like nonsense. I fell and the whole side of my face dropped.'

Amanda, 35, was taken to hospital where medics diagnosed a stroke and she spent 22 days being treated. She says: 'It took me three months to learn to talk and walk again.'

Amanda feared she might never return to work. At the time of the stroke, in November 1998, their children, Colby and Abigail, were only three years old and six months.

Fortunately, the financial pressure was blunted because she and husband Robert, a lorry driver, had taken out life cover and critical illness insurance alongside their mortgage payment protection policy.

Four months after the attack, Abigail was back at work part-time in a High Street chemist's shop where she is now a full-time business manager. She still has to take four types of drugs and is regularly monitored for high blood pressure.

At first, though, the couple did not realise the significance of their critical illness plan and claimed only on their mortgage payment protection policy. But because they had reduced their premiums by choosing a 90-day delay before any claim paid out, it covered only one month of mortgage repayments.

Amanda says: 'It wasn't until we went to ask for a loan advance on our mortgage more than a year later that the adviser at our lender, Norwich & Peterborough, told us we could claim on our critical illness plan.'

Normally, there is a one-year cut-off, but because the couple had already claimed on their payment protection, Amanda's request was accepted. She says: 'A few months later, our £32,000 mortgage was paid off. It really has made a big difference.

'We also took the mortgage advance, which we used to do up our kitchen and buy a dining room table. And we bought the first new car we've ever had rather than driving around in an old banger. Our life is much better because there is less financial worry.'

Worrying about money is the last problem a family needs if a breadwinner falls seriously ill, which is why many people take out insurance against sickness.

Two types of insurance can help families faced with the hardships that long-term sickness can bring. A critical illness policy pays a taxfree sum on the diagnosis of a serious illness such as cancer. Income replacement pays a regular income for as long as a policyholder cannot work.

The cover is usually taken out alongside a mortgage or other loan so that the debt can be cleared in the event of serious health problems-Often it is combined with life insurance. It is ideal for policyholders who suffer a disease such as cancer, or a heart attack or stroke because they receive a payout even if, like Amanda, they make a full recovery.

Most policies cover at least these three main illnesses. However, most also pay out for heart bypass operations, kidney failure, major organ transplants, multiple sclerosis and strokes. Some policies add a dozen or more diseases, such as Alzheimer's, Parkinson's, blindness and permanent disability.

Sarah Windsor-Lewis, an independent adviser with PDFM in Guildford, Surrey, encourages clients to think about critical illness cover as a financial priority.

She says: 'With one in three people contracting cancer at some point in their lives, and one in four suffering from heart disease, it is worth considering this type of benefit. A payout might not make you better, but it can provide a financial breathing space at a difficult and emotional time and allow you to cut work commitments.'

Policyholders should check the small print closely for exclusions, as there are many. For example, claims for skin cancer are generally rejected unless the policyholder is diagnosed with invasive malignant melanoma. Similarly, a claim from someone who has undergone a balloon angioplasty to clear arteries is likely to be rejected as this is now considered a routine operation.

One serious drawback with critical illness insurance is that premiums are rising in response to a deluge of claims. Consequently, sales are falling. In 1999, providers sold £45m worth of policies. Last year, that fell to £33m. And smokers in particular now pay a hefty price for their habit.

Insuresupermarket.com says that a 45-year-old couple who both smoke would pay £367 a month for £150,000 of cover - life and critical illness - over a 20-year term with Scottish Equitable, while their nonsmoking counterparts would pay only £188.

Nor is critical illness cover the most suitable for someone who falls ill with a disease considered non-critical, even if it is debilitating. Conditions such as back trouble or stress are more likely to be covered by income replacement policies, which pay a monthly amount, possibly until retirement age. Insurers stop payment if the client is able to resume his or her work, and some stop when the client can take up any kind of employment. This kind of insurance is not cheap, either, though policyholders may defer the start of payments to keep down premiums.

For example, a 40-year-old man wanting an income of £2,000 a month until 60 would pay £40 a month for a Legal & General plan, assuming he was willing to wait 26 weeks for payments to start. But if he cut the deferral to only 13 weeks, the premium would be £52.

Another point to check is work benefit - some employees will already have cover. Windsor-Lewis says: 'If this is the case, cover should not be purchased as the insurers will not pay out twice. However, if there is no cover through work, policyholders should consider a plan with a deferment period that coincides with the end of their employer's sick pay arrangements.'